Guns are the leading cause of death for children in the US. A pediatric trauma surgeon describes the physical toll gun violence takes on victims.
As of 2020, guns surpassed car crashes as the leading cause of death in the United States for children. The rate of child firearm death spiked 42 percent in the last two decades, according to the Kaiser Family Foundation. In this regard, the US stands alone among comparable countries.
While school shootings, like the one at the Covenant School in Nashville this week that resulted in the deaths of three children and three adults, tend to get the most attention, they are only a small part of the overall picture. The overwhelming majority of kids who die by guns are victims of homicide in their homes and communities, suicides, or unintentional injury. Black children are disproportionately represented in the population of those killed. The rate of gun suicides among kids has been rising, too.
Dr. Chethan Sathya, a pediatric trauma surgeon and the director of Northwell Health’s Center for Gun Violence Prevention, has treated children for gunshot wounds, and has made ending gun violence a central focus of his career. Vox spoke with Sathya about his experiences treating children, and what he thinks needs to be done to address a stark — and growing — crisis.
This interview has been edited for length and clarity. Please note that while there are no images of violence accompanying this interview, there are descriptions that some readers might find disturbing.
What’s it like to treat children for gunshot wounds?
I’m part of a trauma team. It’s like 30 people in one room, all waiting and ready for a patient. When it’s a kid coming in with a bullet wound, that room is silent. What’s this kid gonna look like? There’s all this emotion around it. It’s a very tense situation, and it’s way quieter than other trauma bays, because I think everybody is, at some level, scared. You never want to lose a life, but just having a child in front of you that has bullets in them and is bleeding out or could die — that’s a very traumatic thing.
The parents come into the trauma bay with us. So you’re dealing with a child with a bullet injury, and the parents are there. You can only imagine how traumatic a situation that is, and the immense horror on the faces of these parents.
You can’t help but reflect on your own kids. I’m a father myself. You start thinking about the fact that you don’t want to lose this child, and then you do everything you can to treat the injury. It’s a hard thing to grapple with. It doesn’t ever become easier.
What do bullets do to children’s bodies? Are there differences in terms of how they affect kids versus adults?
When it comes to children, people don’t understand: Everything, all their vital organs, the big blood vessels, they’re all that much closer together. And unlike with an adult, there’s no buffering from abdominal fat, or protection from muscles. When you look on the outside, you might just see a bullet hole. But when we, as surgeons, open up that child, we see the devastation on the inside.
